Asset management is a term that may be used in a number of contexts. However, the general definition of asset management is centered on the management of various valuables which may either be tangible or intangible. It has been used widely in the financial industry where banks and other institutions manage asserts for other parties. The term, however, extends to various industries such as the infrastructure, enterprise, and public industries among others.
In this case study, the industry that is under scrutiny is the infrastructure sector. In this case, the term is used to define the management of the physical assets with the main aim of providing a predetermined level of service (Matthew, et al., 2012). The management, therefore, falls on the finances, economies, technological methods that may be applied in raising the performance of the physical assets. Regardless of the improvements and the necessary modifications made to these assets, the level of service to be provided afterward has to be cost-effective and can be easily met with the public.
The case study presented revolves around the emergency department of the University Hospitals NHS trust. Generally stated, the trust plays a fundamental role in delivering service to the patients with the services provided to over 1 million people. Therefore, ensuring that it provides the necessary level of service to every person is critical. The service to be provided extends over three main sites but the emergency department is located in only one site, site A. The site and the departments are inadequate and improperly planned which has resulted in poor service delivery, the flow of the patients, the capacity and other issues.
It has been stated that the patient inflow is expected to increase with the estimation that the emergency service requirements increases by 5% each year. On the other hand, the medical assessment activities are also on the increase with the estimates indicating a 3.5 annual increase in the demand for these services.Considering that the trust has three locations under its leaf, there are three proposals on the development of the of the emergency as well as the medical assessment unit. All the three options have various requirements and modifications but as has been decided, option C present the best option. Option C is the modification of the first hospital site with the major emphasis on the refurbishment of the current emergency department and the construction of a new emergency department within the site.
Modifications and improvements of this site are centered on the financial capability of the University trust’s financial status and the returns expected. However, the financial status for the past years has not been so pleasing with various deficits occurring during the year 203/2014.However, the main levies that are to be used in the project are expected from various bodies such as the Clinical Commissioning Groups, NHS England, and education and training. As such, monetary management is very important for the development of the emergency department.
Therefore, there are various issues to be associated with the asset management framework to be used. This report is going to look at all the three case studies and try to build a proper framework that shows the relationship between asset management and all the evidence provided. Furthermore, the report will look at the responsive nature of the technique and its need in an ever-changing stakeholder expectation environment.
Framework of asset management
As it has been stated before, the case study provides three hospitals that fall under the University Hospitals NHS Trust. The ability of an organization to manage its asset effectively which translates to managing the success of the company is based on the framework adopted. An asset management framework tends to be used by organizations that are asset intensive, enabling the organization to go through the whole process in an effective manner. Therefore, the asset management framework is intended to improve the efficiency, effectiveness and the performance while at the same time keeping in reach the goals and objectives of the organization (Lowe & Leirringer, 2008).
The asset management framework has to consider three ingredients for its effectiveness and efficiency. The three components of the framework are the people, the technology employed and the process. The nature of these components is very crucial in determining the success of the framework employed. Furthermore, the maturity level determines the consistency as well as the sustainability. Therefore, the asset management technique that is applied by any organization has to be maintained with minor modifications being made every once in a while. As a matter of fact, the framework employed plays a vital part in the consistency of the performance as well as the sustainability which in turn means the performance of the organization (Maheshwari, 2006).
The asset management framework used in the three hospital cases will have to meet the expectations of the stakeholders and the activities that are to be undertaken. The stakeholders, in this case, include the patients, staff, volunteers, emergency staff and the external group among others.
The strategic management framework to be employed in this case has to be of three dimensions. The three dimensions generally focus on all the stakeholders, their expectations and the management practice employed (Jepsen & Eskerod, 2009). Furthermore, the planning has to ensure that all the expectations and the organizational structure are highly integrated. Integration is a huge part of asset management considering the various groups to be involved in the development of the three hospitals. Therefore, the framework is based on the following three levels: the management of the hospital trust, the life cycle of the asset and asset and requirements of the organization.
To begin with, the framework has to be centered on the management with the levels in this case described as four. These four levels of management include the strategies from the government, the management of facilities, the conduct of the works and the strategies of the agency (Ponnappa, 2014). By combining all these factors, the framework ensures that the blueprint outlining the prospect of development is fully covered. The hospital trust has a number of stakeholders including the council which are an extension of the government. These agencies generally outline the proper standards to be met in the design and development of the emergency department. As it has been outlined, there are various health and safety standards that should be met in the refurbishment as well as the construction of the three hospital sites. The second level in the management are the strategies of the trust fund. The development has to ensure that all the objectives are met with the emphasis on those that the trust deems appropriate. Some of the requirements by the hospital trust include: the need to meet the increasing service demand, need for better and quality services among others.
The third management levels mainly deal with the daily operations of the emergency department. The increased number of patients requiring emergency services has prompted the trust to come up with the three options and before specifically selecting one, the demolition, construction, and refurbishment strategies have been reviewed. The strategies focus on the day to day operations and therefore the three proposals have focused on the adjacencies, the ambulance delivery as well as the emergency department. The main focus has been on the effective service delivery with some of the modifications including the bridging a number of departments which include the emergency, the maternity access etc. Furthermore, demolition of some building structures within the site is a necessity if the development is to consider developing new and better departments.
Finally, there are the conducts of works focusing on specific hospital assets. The management of assets which play a vital role in the operations of the emergency department is very crucial considering that the day to day operations depend on these assets. However, with the development of the new building structures as well as the demolition of others, the management will have to consider the important assets such as ambulances and the changes that will come with the modification of the emergency department.
Below the management level is the life cycle skills which are required in transitioning the emergency department from the current state to a better one. In this, there are generally four levels that asset management framework provides: planning, procurement services, maintenance and disposal of the assets. To begin with, the planning has to consider all the service delivery methods available with the option giving the highest benefit-cost ratio likely to be used. The refurbishment, as well as the demolition services, consider all the service delivery options with the main emphasis on efficiency. Being efficient in a hospital is fundamental to the well-being of all the patients and other stakeholders and as such, proper planning is a necessity.
Secondly, the life cycle has to consider the procurement of services and assets. The demolition and refurbishment of the building s is an intensive process that requires the planners to effectively manage all the refurbishment and demolition processes. Furthermore, the contractors chosen have to meet the requirements adequately prior to the actual contractual agreement. The third level is centered on the management with the basic requirement that all the activities undertaken to be at a minimal on the operational costs. Buildings that tend to be neglected have a higher operational cost and as such, the refurbishment has to consider the proper and regular maintenance of all the assets during operation, which in turn will reduce risks. Finally, there is the level that involves the disposal of some of the assets associated with the project and as in this case, the refurbishment and construction have to be in line with the latest hospital building standards.
The final level is that of the organizational skills. Increasing the emergency delivery capabilities of the hospital will require additional services particularly from the health workers. In this, there are four requirements which include the structure of the organization and the processes, the level of skills in the staff, the resources available and the management and delivery of information within the organization. To begin with, the organization should consider how the assets are distributed within the organization which generally means the different requirements of service delivery within the organization (Eskerod & Huemann, 2013). Secondly, the skillset of the staff should be adequate to manage the delivery of services. Thirdly, the allocation of resources should meet the different system requirements within the organization and finally, information should be adequately delivered in order to ensure that everyone is up to date with the necessary requirements.
Responsive nature of the asset management framework
There is the need for the asset management framework employed in the above scenario to be very responsive to the nature and demands of the stakeholders. The asset lifecycle is the major issue because it is influenced by numerous internal as well as external factors. In this, the asset lifecycle is to be profiled from the financial as well as the non-financial orientations with the need for an impromptu modification looked.
The asset management lifecycle is very much prone to design and redesign concepts which generally affect the asset management framework. Therefore, the management has to consider various long-term factors which may involve increased costs and other implications for the organization. In the hospital design and refurbishment, the asset is likely to affect the operational costs which in turn might affect the affordability of the services to the patients.
The need for reinvestment is another factor that the framework should consider. This plays a major role in information disbursement within the organization .and is usually brought about by the changes that usually occur in the environment, the business and the operation of the asset.Therefore, the framework needs to understand these different changes and provide proper communication strategies that are meant to alert the stakeholders. The responsive nature of the framework determines the ease with which the hospital trust may understand and implement these varying changes.
The responsive nature of the framework determines the ability of the organization to adapt to the various stakeholder changes. Though the framework might be designed in such a way that it satisfies all these changes, the project manager may be the one in the most of unsuitable situations. This is because he has to manage the various changes without damaging the framework already in place while at the same time meeting the expectation of each stakeholder.
The initial design and implementations are usually overlooked by the project manager and in case of any change within the asset, he/she is responsible for the transition.Therefore, this might be a problem when the changes are not feasible and cannot be easily implemented. The project manager is mandated with the responsibility of keeping the benefit-cost ratio at a desirable level and therefore, changes in the stakeholders’ expectations might lead to a lower benefit-cost ratio which might put him/her in a precarious situation.
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